Effects of oral rehydration therapy on gastric volume and pH in patients with preanesthetic H2 antagonist
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Recent preanesthetic fasting practice allows patients to take clear fluids up to 2 h before surgery without taking any antacid for the prophylaxis of aspiration pneumonia; this practice is defined as oral rehydration therapy (ORT). It has been reported that with ORT the gastric volume may be significantly lower than that with a standard fasting regimen, although in a standard fasting regimen without preanesthetic antacid, gastric pH and volume values could be critical for causing aspiration pneumonia. In this study we compared gastric fluid status in patients with ORT and those with a standard fasting regimen; patients in both groups received a preanesthetic H2 antagonist. One hundred and four patients were randomly assigned to either the ORT or standard fasting group, and all were given roxatidine 75 mg 2 h before surgery. After the induction of anesthesia, the gastric contents were collected via a gastric tube to measure gastric volume and pH. Neither gastric volume nor pH differed between the groups (ORT 9.6 ± 8.2 ml and 5.6 ± 1.7, respectively, vs. standard fasting 8.5 ± 6.8 ml and 5.5 ± 1.7, respectively). These data suggest that ORT may not reduce gastric volume in patients receiving a preanesthetic H2 antagonist.
- Hirota K, Kushikata T. Preanaesthetic H2 antagonists for acid aspiration pneumonia prophylaxis. Is there evidence of tolerance? Br J Anaesth. 2003;90:576–9. CrossRef
- Smith I, Kranke P, Murat I, Smith A, O’Sullivan G, Søreide E, Spies C, in’t Veld B, European Society of Anaesthesiology. Perioperative fasting in adults and children: guidelines from the European Society of Anaesthesiology. Eur J Anaesthesiol. 2011;28:556–69. CrossRef
- American Society of Anesthesiologists Committee. Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: application to healthy patients undergoing elective procedures: an updated report by the American Society of Anesthesiologists Committee on Standards and Practice Parameters. Anesthesiology. 2011;114:495–511. CrossRef
- Ljungqvist O, Søreide E. Preoperative fasting. Br J Surg. 2003;90:400–6. CrossRef
- Brady M, Kinn S, Stuart P. Preoperative fasting for adults to prevent perioperative complications. Cochrane Database Syst Rev. 2003;4:CD004423.
- Itou K, Fukuyama T, Sasabuchi Y, Yasuda H, Suzuki N, Hinenoya H, Kim C, Sanui M, Taniguchi H, Miyao H, Seo N, Takeuchi M, Iwao Y, Sakamoto A, Fujita Y, Suzuki T. Safety and efficacy of oral rehydration therapy until 2 h before surgery: a multicenter randomized controlled trial. J Anesth. 2012;26:20–7. CrossRef
- Hirota K, Kudo M, Kushikata T, Hashimoto H, Matsuki A. Regular use of H2 blockers reduces the efficacy of roxatidine to control gastric pH and volume. Can J Anaesth. 2005;52:166–71. CrossRef
- Hirota K, Kudo M, Hashimoto H, Kushikata T. The efficacy of preanesthetic proton pump inhibitor treatment for patients on long-term H2 antagonist therapy. Anesth Analg. 2005;101:1038–41. CrossRef
- Agarwal A, Chari P, Singh H. Fluid deprivation before operation. The effect of a small drink. Anaesthesia. 1989;44:632–4. CrossRef
- Phillips S, Hutchinson S, Davidson T. Preoperative drinking does not affect gastric contents. Br J Anaesth. 1993;70:6–9. CrossRef
- Somwanshi M, Tripathi A, Singh B, Bajaj P. Effect of preoperative oral fluids on gastric volume and pH in postpartum patients. Middle East J Anesthesiol. 1995;13:197–203.
- Maltby JR, Pytka S, Watson NC, Cowan RA, Fick GH. Drinking 300 mL of clear fluid two hours before surgery has no effect on gastric fluid volume and pH in fasting and non-fasting obese patients. Can J Anaesth. 2004;51:111–5. CrossRef
- Hashimoto H, Kushikata T, Kudo M, Hirota K. Does long-term medication with a proton pump inhibitor induce a tolerance to H2 receptor antagonist? J Gastroenterol. 2007;42:275–8. CrossRef
- Cook T, Woodall N, Frerk C. Results of the second phase of NAP4: overall results and anaesthesia. In: Cook T, Woodall N, Frerk C, editors. 4th National Audit Project of The Royal College of Anaesthetists and The Difficult Airway Society: major complications of airway management in the United Kingdom. London: The Royal College of Anaesthetists and The Difficult Airway Society; 2011. p. 29–40.
- Auroy Y, Benhamou D, Péquignot F, Bovet M, Jougla E, Lienhart A. Mortality related to anaesthesia in France: analysis of deaths related to airway complications. Anaesthesia. 2009;64:366–70. CrossRef
- Effects of oral rehydration therapy on gastric volume and pH in patients with preanesthetic H2 antagonist
Journal of Anesthesia
Volume 26, Issue 6 , pp 936-938
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- Springer Japan
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- Oral rehydration therapy
- H2 antagonist
- Gastric acidity
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